Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2025 Jan 1;64(1):56-64.
doi: 10.1093/rheumatology/keae399.

Subclinical psoriatic arthritis and disease interception-where are we in 2024?

Clementina López-Medina  1   2   3 , Dennis McGonagle  4 , Laure Gossec  3   5
Affiliations
Review

Subclinical psoriatic arthritis and disease interception-where are we in 2024?

Clementina López-Medina et al. Rheumatology (Oxford). .

Abstract

Psoriatic arthritis (PsA) is a chronic rheumatic disease that usually appears in patients with skin psoriasis, making it a model for detection of joint disease in the pre-clinical phases in a setting where therapy for cutaneous disease may ameliorate or prevent arthritis development. Such PsA prevention appears credible due to the increasingly recognized closely shared immunopathology between the skin and joints, especially the entheses. Recently, several initiatives have explored the concept of pre-clinical PsA, and nomenclatures have been developed with the recent EULAR nomenclature proposing a simplified three stages from psoriasis to clinical PsA development, namely at risk of PsA, subclinical PsA and early PsA. A better comprehension of early PsA and the identification of individuals predisposed to its development could enable interventions to 'prevent' the appearance of PsA. Several recent retrospective observational studies have demonstrated disease interception feasibility, i.e. treatment of people with psoriasis may prevent the appearance of PsA, in particular using biologic disease-modifying drugs. However, further data are urgently required due to unexpected findings in some studies where TNF inhibition for psoriasis does not reduce the rate of PsA development. In this review we address the current challenges in early PsA, including comparisons of pre-PsA nomenclature sets, its risk factors and the potential for disease interception.

Keywords: DMARDs; epidemiology; psoriatic arthritis; skin; spondylarthropathies; spondyloarthritis.

PubMed Disclaimer

Figures

None
Graphical abstract
Figure 1.
Figure 1.
Phases proposed to explain the transition from PsO to PsA [21–23]. PAMPA: Preventing Arthritis in a Multicentre Psoriasis At-Risk Population; PsA: psoriatic arthritis; PsO: psoriasis
Figure 2.
Figure 2.
Emerging basis for PsA prevention based on therapy of psoriasis. ILC: innate lymphoid cells; JAK: Janus kinase; MAIT: mucosal-associated invariant T cell; PDE4: phosphodiesterase-4; PsA: psoriatic arthritis; TRM: tissue-resident memory T cell; TYK2: tyrosine kinase 2
See this image and copyright information in PMC

References

    1. Ritchlin CT, Colbert RA, Gladman DD.. Psoriatic arthritis. N Engl J Med 2017;376:957–70. - PubMed
    1. FitzGerald O, Ogdie A, Chandran V. et al. Psoriatic arthritis. Nat Rev Dis Primers 2021;7:59. - PubMed
    1. Alinaghi F, Calov M, Kristensen LE. et al. Prevalence of psoriatic arthritis in patients with psoriasis: a systematic review and meta-analysis of observational and clinical studies. J Am Acad Dearmatol 2019;80:251–65.e19. - PubMed
    1. Ogdie A, Langan S, Love T. et al. Prevalence and treatment patterns of psoriatic arthritis in the UK. Rheumatology (Oxford) 2013;52:568–75. - PMC - PubMed
    1. Smolen JS, Schöls M, Braun J. et al. Treating axial spondyloarthriits and peripheral spondyloarthritis, specially psoriatic arthritis, to target: 2017 update of recommendations by an international task force. Ann Rheum Dis 2018;77:3–17. - PMC - PubMed

Substances

Grants and funding